we haven’t heard any concrete dates about when he might be ready to go home, but his neonatologist told us today that they are going to consult with surgeons and various specialists and come up with a plan on thursday morning! i don’t think he’ll be going home on thursday, but they said that we’ll have a much more concrete idea on thursday evening about what steps need to be taken in order for him to be discharged! if everything continues to improve, i think we’ll be busting out of the nicu, very, very soon. of course, we’re vigilent of falling victim to the the curse of the nicu and we’re careful to not ever mention that he might be coming home when we’re by his bedside. all the nurses are familiar with the curse and completely understand when we spell out h-o-m-e as we’re discussing the issue within earshot of odin .
it might have been a little bit of an overstatement to say that his reflux disappeared. every so often he lets us know that he’s still refluxing, even though he’s sending very little milk out his nose or mouth. despite the occasional desats, he’s still doing quite well – although his doctors admit that they don’t know exactly how to account for his speedy recovery when just last week it seemed that he was a good candidate for surgery.
the third green line from the top shows a running tally of his heartrate and on the left side of the screen you can see a substantial dip of over 60 beats per minute which occurs when milk has started go up into his esophagus stimulating nerves that slow his heartrate.
the blue line below the green line shows his blood oxygen saturation level and you can see that it also dipped ( known as a “desat” ) as a result of his slower heartrate. his blood oxygen saturation fell below slightly below 80% which is enough to make the alarm go off, but not enough to make him change skin color from pink to blue.
the desat alarm is not too bid a deal, but if his heartrate has continued to fall below 80 beats per minute then a different alarm would have sounded indicating that his heartrate had fallen dangerously low at which point he’d be having an episode known as bradycardia.
when pressed to give the odds, his doctors still think that he has a 30-40% chance of needing the nissen and g-tube surgeries, although obviously they’re getting confident enough to begin the discussions about when he might be able to come home. despite the fact that the odds are increasingly in favor of not performing the surgeries, the doctors indicated that they’ll probably send him home with his inguinal hernia unrepaired on the chance that he’ll eventually need the hiatal hernia, nissen and g-tube surgeries, thus diminishing the chance of needing to put him on the ventilator several different times ( in other words, they’ll hedge their bets and vent him once and perform whatever surgeries they need to perform all at one time ). also, despite being caffeine free, they said that they will probably send him home on a “home monitor”, since they’re not sure if his reflux will return after being sent home.
since it’s impossible to know if his heartrate is fluctuating and he’s desatting when he’s not showing obvious signs of refluxing, i have to admit that i feel a little more secure knowing that he might be coming home “wired”.